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局部麻醉用于控制第一季度的疼痛手术堕胎手术堕胎
Regina-Maria Renner1, Madeleine Ennis1, Adrienne E McKercher1
1Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada.
The Cochrane database of systematic reviews
|February 13, 2024
概括
一个20毫升1%的普通利多卡因椎阻断剂 (PCB) 有效地减少了早期手术堕胎期间的疼痛. 有证据支持放弃缓冲利多卡因和等待期,注射点较浅,较少,足以缓解疼痛.
科学领域:
- 妇科 妇科医生 妇科
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 在怀孕14周之前进行手术堕胎是一种常见的程序.
- 尽管有可用的疼痛控制方法,但许多人经历疼痛.
研究的目的:
- 评估局部麻醉在早期手术堕胎期间控制疼痛的益处和危害.
- 评估各种局部麻醉剂和施用技术.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 在多个数据库中搜索到2022年12月的相关研究.
- 包括对手术堕胎 (<14周妊娠期) 疼痛控制局部麻醉剂进行比较的RCT.
主要成果:
- 与假装PCB (高确定性证据) 相比,20毫升1%的普通利多卡因副椎阻塞 (PCB) 显著降低了扩张和吸收期间的疼痛.
- 缓冲性利多卡因,等待期,更深的注射和四位点PCB与简单方法相比没有显著改善.
- 局部宫麻醉显示不一致的结果,并没有例行支持;报告的不良事件很少.
结论:
- 一个20毫升的1%纯利多卡因PCB是有效的管理疼痛在早期的手术堕胎.
- 优化的PCB技术,包括避免缓冲,等待时间和使用更少/更浅的注射,得到证据的支持.
- 如果有,建议使用有意识镇静,PCB和NSAIDs的联合治疗,以增强疼痛缓解.
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